[Increased cataract rate and characteristics of Nd:YAG laser capsulotomy in retinitis pigmentosa].
BACKGROUND
Retinitis pigmentosa (RP) is associated with the development of a posterior subcapsular cataract (PSC). The development of posterior capsule opacification (PCO) after cataract surgery and a decrease of central visual acuity is sometimes misinterpreted by the patients as natural course of RP. Therefore, therapeutic intervention is often delayed.


METHODS
In a retrospective study (part 1) the incidence of PCO was evaluated in a group of 26 RP patients who underwent cataract surgery and IOL implantation. In a prospective analyse (part 2) PCO was quantified in 13 RP patients using the standardized photographic technique and image analysis system introduced by Tetz et al. Matched pairs were formed with a control group of 13 patients without retinal disease who matched the RP group in terms of age distribution and postoperative follow-up time. In part 3 the parameters of Nd:YAG laser capsulotomy in 12 RP patients and 14 controls were evaluated.


RESULTS
Part 1: The cumulative PCO rate in RP at the end of the first postoperative year was 14.6%, 26.8% in the second, 53.7% in the third and 70.7% after the third year. Nd:YAG laser capsulotomy was performed in 70% of eyes (after 18.4 +/- 14.7 months). In eyes with significant PCO development 70% had PSC preoperatively, while in eyes without PCO formation only 41.7% showed PSC. Part 2: The matched pairs analysis showed a significantly higher PCO value for RP patients (2.11 +/- 1.42) than for the control group (0.89 +/- 0.72) (P = 0.038). Part 3: Average Nd:YAG laser energy levels were 12.8 +/- 11.2 MJ (RP) and 7.6 +/- 6.7 MJ (control). Some 25% of RP patients required further laser treatment of regrown secondary cataract.


CONCLUSIONS
Patients with RP showed a significantly higher incidence and density of PCO. Whether RP-specific pathomechanisms are responsible for this needs further investigation.
Auffarth
G U
GU
Augenklinik der Ruprecht-Karls-Universität Heidelberg.
Nimsgern
C
C
Tetz
M R
MR
Krastel
H
H
Völcker
H E
HE
D000328:Adult; D000368:Aged; D002386:Cataract / Q000175:diagnosis / Q000209:etiology*; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D007910:Lenses, Intraocular; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012174:Retinitis Pigmentosa / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity
Erhöhte Nachstarrate und Besonderheiten der ND:YAG-Laserkapsulotomie bei Retinitis pigmentosa.